{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T12:26:04Z","timestamp":1765369564887,"version":"3.40.5"},"reference-count":22,"publisher":"Instituto Nacional de Salud (Colombia)","issue":"1","content-domain":{"domain":["revistabiomedica.org"],"crossmark-restriction":false},"short-container-title":["biomedica"],"abstract":"<jats:p>Introducci\u00f3n. El trauma craneoencef\u00e1lico es una de las principales causas de muerte y discapacidad en adultos j\u00f3venes. Su gravedad se define seg\u00fan la escala de coma de Glasgow. Sin embargo, el deterioro neurol\u00f3gico agudo no siempre concuerda con la gravedad inicial indicada por la escala, lo que implica una subestimaci\u00f3n de la magnitud real de la lesi\u00f3n.Objetivo. Estudiar la correlaci\u00f3n entre la gravedad inicial del trauma craneoencef\u00e1lico seg\u00fan la escala de coma de Glasgow y la condici\u00f3n final del paciente, en el contexto de diferentes variables cl\u00ednicas y de los hallazgos de la tomograf\u00eda.Materiales y m\u00e9todos. Se analiz\u00f3 una cohorte retrospectiva de 490 pacientes con trauma craneoencef\u00e1lico cerrado que requirieron atenci\u00f3n en la unidad de cuidados intensivos de dos centros de tercer nivel de Barranquilla. La estimaci\u00f3n del riesgo se estableci\u00f3 con la raz\u00f3n de momios (odds ratio, OR) y un intervalo de confianza (IC) del 95 %. Se utiliz\u00f3 un alfa de 0,05 como nivel de significaci\u00f3n.Resultados. El 41,0 % de los pacientes requiri\u00f3 intubaci\u00f3n endotraqueal; el 51,2 % hab\u00eda presentado traumas inicialmente clasificados como moderados y, el 6,0 %, como leves. El retraso en la implementaci\u00f3n de un tratamiento agresivo afect\u00f3 principalmente a aquellos con trauma craneoencef\u00e1lico moderado, en quienes la letalidad aument\u00f3 al 100 % cuando no se detect\u00f3 a tiempo el deterioro neurol\u00f3gico y, por lo tanto, el tratamiento agresivo se demor\u00f3 m\u00e1s de 4 a 8 horas. Por el contrario, la letalidad fue de menos de 20 % cuando se brind\u00f3 el tratamiento agresivo en el curso de la primera hora despu\u00e9s del trauma.Conclusiones. El riesgo de letalidad del trauma craneoencef\u00e1lico aument\u00f3 cuando el deterioro neurol\u00f3gico se detect\u00f3 tard\u00edamente y el tratamiento agresivo se inici\u00f3 despu\u00e9s de transcurrida la primera hora a partir del trauma.<\/jats:p>","DOI":"10.7705\/biomedica.4786","type":"journal-article","created":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T15:56:37Z","timestamp":1584633397000},"page":"89-101","update-policy":"https:\/\/doi.org\/10.7705\/crossmark","source":"Crossref","is-referenced-by-count":5,"title":["La detecci\u00f3n tard\u00eda del deterioro neurol\u00f3gico agudo incrementa la letalidad por trauma craneoencef\u00e1lico."],"prefix":"10.7705","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6424-7254","authenticated-orcid":false,"given":"Alexander","family":"Rodr\u00edguez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliana","family":"Cervera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Tuesca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Fl\u00f3rez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Romero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro J.","family":"Villalba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4444","published-online":{"date-parts":[[2020,3,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Menon DK, Schwab K, Wright DW, Maas AI. 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